Colour Patch Test Signature Form

Viva Hair Design Ltd, Bank House, Clay Hill, West Road, Goudhurst, TN17 1AB

Company No. 04136561 VAT No. 763109634

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Full Name*

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Email address*

Phone number*

Have you used any box dyes in the last 3 months?*

Yes

No

Have you had a vaccine within a week of your appointment with us?*

Yes

No

Have you ever tested positive for COVID-19?*

Yes

No

Consent Agreement (GDPR)*

Yes, I would like to be contacted via email or phone.

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Viva Hair Design Ltd, Bank House, Clay Hill, West Road, Goudhurst, TN17 1AB

Company No. 04136561 VAT No. 763109634

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